Life Services® Ohio Referral Form

If you would like to learn more about CareSource Life Services, please fill out the form below. Note: You don’t have to enroll.

You also can reach us at 1-844-543-7378 (TTY: 771) or by email at We are open Monday through Friday, 8 a.m. – 5 p.m. We look forward to hearing from you!

This is NOT an Enrollment Form

OH-MULTI-M-2282823 ODM Approved: 9/14/2023